Lila H. Abu-Hilal, Yumna M. Njoom, Duha I. Barghouthi, Yazan Abu Thraiee, Sameer Mtour
Langerhans Cell Histiocytosis (LCH) is a rare condition with an unknown etiology and variable manifestations that include lung infiltrates, bone lesions, rashes, endocrine, hematopoietic and hepatic dysfunction. It results from neoplastic proliferation of Langerhans cells. Eosinophilic Granuloma (EG) is considered a localized form of the disease.
Here, we report a case of a 5 year-old female patient who presented with a left frontal 3 cm non-tender swelling that had grown rapidly during 2 months. Head Computed Tomography showed a 3 cm lytic bone lesion, while head Magnetic resonance imaging showed extra-axial space occupying lesions with irregular borders and meningeal infiltration. The patient was hence diagnosed with Eosinophilic Granuloma of the skull one year after she was hit on her left frontal skull with a hammer, without a history of hemorrhage or fracture. Total excision was performed through cranioplasty, and full investigations were done to rule out systemic involvement that were all free.
To conclude, EG should be considered in pediatric patients with a history of head trauma even without trauma complications.